Home doctors bracing for Medicare cuts in budget

Home doctors fear the axe is about to fall on Medicare-funded, after-hours visits to millions of Australian households each year, resulting in after-hours patients being pushed towards already stretched hospital emergency departments.

The National Association for Medical Deputising Services is so concerned about the signals emanating from Health Minister Greg Hunt and his departmental bureaucrats, it has commissioned polling to gauge the popularity of the home visits - which have their own Medical Benefits Schedule numbers.

Television advertising is scheduled to start from this week.

It says the polling conducted on behalf of the organisation has found 74 per cent of Australians would view a reduced home-visits program as a violation of Mr Turnbull's no-cuts-to-Medicare pledge.

The issue is caught up in complex medico-political positioning. One suggestion is that the government will move to truncate the service by requiring that all visits be conducted by a GP - rather than a trainee emergency doctor, as happens at present.

Competitor doctors' organisations, which could stand to benefit from a reconfiguration, share the government's concerns that the service has allowed too many call-outs to be classified as "emergency" visits, triggering a much higher MBS payment than doctors would receive from the standard attendance fee.

The doctors who undertake the home visits through the small hours of the night and morning, assert that reductions would result in patients having to attend hospital emergency departments, thus causing cost-shifting and increased risk.

NAMDS President Dr Spiro Doukakis said: "Doctor home visits are an essential Medicare service and are relied on by two million Australian families - especially carers of people with disability, the elderly and young children.

Health industry sources confirmed the review currently being led by former Australian Medical Association boss Steve Hambleton, is likely to recommend changes to the program amid concerns within the government that the scheme is being "rorted".

Mr Hunt said his commitment to after-hours medical access was "rock-solid".

"But we also have a commitment to ensuring that every service provided is genuine and that every doctor is up to scratch," he said.

"I am concerned about reports that some doctors are claiming to be providing urgent services when they're not urgent at all."

"The advice from the AMA and the RACGP is that some of these junior doctors and corporate firms are claiming for items which are not genuinely urgent."

But Dr Doukakis argued it was actually saving money.

"Whereas the growth in emergency department presentations for genuine emergency issues have grown by an average 26 per cent over the past five years, growth in non-emergencies has basically stopped at 3 per cent off a base of 19 per cent per annum prior to 2011. That shows this is good health policy and its doing its job of easing pressure on hospitals.

"The savings to the health system were calculated by Deloitte Access Economics at $724 million (net savings) over four years. Of course, the savings are to the benefit of state health budgets."